• O Lheureux, C Daper, and F Liénart.
• Services de Médecine Interne, C.H.U. Tivoli. olheureu@ulb.ac.be
• Rev Med Brux. 2012 May 1; 33 (3): 176-8.

AbstractA 64 years old woman was admitted for persistent dry cough. The cough was lasting for one month and was associated with throat clearing, asthenia and low fever mainly at night. A thorough anamnesis also revealed the existence of mild occipital headache. Empirical antibiotic therapy (clarithromycine) had previously been administered without any clinical improvement. Physical examination was normal. However, the blood tests showed an inflammatory syndrome. The diagnostic approach was focused on the lungs, sinuses and digestive tract and did not show any acute disease. The bronchoscopy demonstrated an edematous bronchial mucosa without endoluminal lesion. The results of bacteriological tests performed were negative. Given the age of the patient and the persistence of an inflammatory syndrome of unknown origin, the diagnosis of giant cell arteritis should be excluded, despite an unusual clinical presentation. This hypothesis was supported by a diagnostic biopsy of the right temporal artery, which histological analysis showed characteristic pattern.

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